Evaluation of trigeminal nerve injuries in relation to third

International journal of oral and maxillofacial surgery, 2012

Trigeminal nerve injury is the most problematic consequence of dental surgical procedures with major medico-legal implications. This study reports the signs and symptoms that are the features of trigeminal nerve injuries caused by mandibular third molar (M3M) surgery. 120 patients with nerve injury following M3M surgery were assessed. All data were analysed using the SPSS statistical programme and Microsoft Excel. 53 (44.2%) inferior alveolar nerve (IAN) injury cases and 67 (55.8%) lingual nerve injury (LNI) cases were caused by third molar surgery (TMS). Neuropathy was demonstrable in all patients with varying degrees of paraesthesia, dysaesthesia (in the form of burning pain), allodynia and hyperalgesia. Pain was one of the presenting signs and symptoms in 70% of all cases. Significantly more females had IAN injuries and LNIs (p<0.05). The mean ages of the two groups of patients were similar. Speech and eating were significantly more problematic for patients with LNIs. In concl...

Journal of Craniofacial Surgery, 2010

The objective of this prospective study was to determine the incidence of injury to the inferior alveolar and lingual nerves following surgical removal of impacted mandibular third molars and to evaluate the various factors contributing to the same. A total of 119 patients underwent mandibular third-molar removal during the period of 11 months. Of 119, 3 inferior alveolar nerve and 5 lingual nerve injuries were encountered. Various factors such as lingual retraction, surgical time, operator experience, radiologic findings contributing to the injury were correlated and analyzed.

Although third molar extraction is a routinely carried out procedure in a dental set-up, yet it is feared both by the patient and the dentist due to an invariable set of complications associated with it, especially in the form of nerve injuries. Hence, prior to performing such procedures, it would be wise if the clinician thoroughly evaluates the case for any anticipated complications so that adequate preventive measures can be taken to minimize the traumatic outcomes of the procedure and provide maximum patient care, which would further save the clinician from any sort of litigation.

Purpose: Nerve injury during the removal of third molars in oral surgery is a rare complication; however, it could lead to severe and long-term complications. For this study, data regarding third molar extractions were collected to identify predictive risk factors for inferior alveolar nerve and lingual nerve injuries. Methods: Clinical and radiographic data from Griffith University electronic records were obtained from January 2015 to December 2018. Out of 2826 extractions realised during that period, only fifteen nerve injuries were identified. Results: The incidence of nerve injury encountered was 0.35% for the inferior alveolar nerve and 0.18% related to the lingual nerve, both lower than incidences shown in previous studies. Moreover, no permanent nerve injuries were identified. The mean resolution time for the injuries was eight weeks. This study also identified several risk factors associated with inferior alveolar and lingual nerve injuries, such as the gender and age of the...

Journal of the College of Physicians and Surgeons Pakistan

Objective: To determine the frequency of lingual nerve injury (LNI) during the surgical removal of mandibular third molar and the associated risk factors. Study Design: Descriptive study.

Journal of Maxillofacial and Oral Surgery, 2015

Objective To report the incidence of trigeminal neuropathy seen among new patients in a referral center within a period of 1 year (2013). The cause of damage, method of management and treatment outcome was assessed after 1-year follow-up. Materials and Methods The records of all new patients visiting the oral and maxillofacial unit of the University hospital of Leuven in 2013 were screened for a history of damage to branches of the trigeminal nerve. The selected records were examined and the duration of nerve damage, received treatment as well as the outcome of the neuropathy after treatment was noted after 1-year follow-up. Results 56 patients (21 males, 35 females) from 7602 new patients had symptoms of damage to the trigeminal nerve branch. These symptoms persist in more than onethird of the patients [21/56 (37.5 %)] after 1-year followup. The least recovery is seen from oral surgery, implant placement, orthognathic surgery and tooth extraction. After 1 year 85 % (12/14) of neuropathic pain cases still have their symptoms as compared to 19 % (5/26) of patients with hypoesthesia. Conclusion This study shows a low incidence of nerve damage among the new patients presenting in oral and maxillofacial surgery clinic (\1 %); however, one-third of patients who sustain nerve damage never recover fully. Early diagnosis of the cause of neuropathy is essential. There is a need to objectively assess all patients with symptoms of trigeminal nerve damage before, during and after treatment.

Nepal Journal of Health Sciences

Introduction: Surgical removal of the mandibular third molar has its own set of complications. The mandibular impacted teeth are in proximity to the Inferior Alveolar Nerve (IAN), Buccal Nerve, and Lingual Nerve (LN). Therefore, each of these nerves is always at risk of injury during extraction. Objectives: This study was to evaluate the anatomical risk factors of nerve injury after the surgical extraction of mandibular third molars in patients visiting the department of oral and maxillofacial surgery of People’s Dental College and Hospital. Methods: This prospective study was conducted with 315 participants who presented with a mandibular third molar impaction and underwent Intraoral Periapical Radiograph (IOPAr), panoramic radiograph, as well as Cone Beam, Computed Tomography (CBCT). CBCT was done in those patients in which the mandibular third molar was in close contact with the mandibular canal. Results: Collected data from 315 patients showed that the incidence of Inferior alve...

The Professional Medical Journal, 2020

To assess the nerve injury (inferior alveolar nerve) after surgical removal of mandibular third molars under local anesthesia. Study Design: Observational study. Setting: Oral & Maxillofacial Surgery Department LUMHS Jamshoro/Hyderabad. Period: From 11th November 2015 to 10th May 2016. Material & Methods: This study consisted of one hundred patients. Inclusion criteria’s were patients with impacted mandibular third molar, patient’s age from 18 to 45years and irrespective of gender. Exclusion criteria were patients younger than 18yrs of age of above 45 years, patients having neurological disorders, medically compromised patients, patients receiving radiotherapy or chemotherapy, patients with known allergy to local anesthesia, patients having pathology due to mandibular third molars, patients radiographicaly root is very near to inferior dental canal. Results: Out of 100 patients incorporated in this research 66 were male (66%) and 34 female (34%). The mean age was 29+3.20 years. Comm...

National Journal of Maxillofacial Surgery, 2011

The surgical removal of impacted mandibular third molar is associated with minor but expected complications like pain, swelling, bruising and trismus. The lingual nerve damage sometimes occurs after the removal of mandibular third molar producing impaired sensation or permanent sensory loss. This complication is usually unexpected and unacceptable for the patients particularly if no prior warning has been given. [1] The incidence of lingual nerve injury may occur because of surgeon's inexperience, procedure methodology and certain specific factors such as raising and retracting a lingual mucoperiosteal flap with a Howarth periosteal. [2] Rood [3] (1983) reported an initial incidence of 6.6% lingual nerve injury, Blackburn and Bramley, [2] 11% and VonArx and Simpson (1997) reported 22%. The exact mechanism of lingual nerve damage during third molar surgery is controversial and amongst the most studies causes are lingual plate perforation and lingual flap trauma during ostectomy or tooth sectioning, usage of lingual flap retractor and supra-crestal incision because the nerve can be located in this region in some cases and

Medical Principles and Practice, 2010

Objective: The objective of this study was to estimate the frequency of postoperative lingual nerve (LN) impairment after the surgical removal of mandibular third molars (M3) and to identify potential risk indicators. Subjects and Methods: A prospective cohort study involving 321 subjects who had 443 mandibular M3 surgically extracted at the University Hospital, Amman, Jordan. Predictor variables were categorized as patient-, anatomy- and operation-specific. The outcome variable was the presence or absence of LN impairment. Bivariate and multivariate analyses were performed to identify independent predictors. Results: The prevalence of temporary LN hypoesthesia was 2.5% and all 11 cases resolved within 6 months. Factors that predicted LN injury by univariate analysis were horizontal and mesioangular tooth angulation, bone removal, tooth sectioning, longer operations, lingual flap retraction and bleeding into the socket. In the multivariate logistic regression model, lingual flap ret...